My Forthcoming Book on Pain

My book, to be called A Nation in Pain: Treating Our Biggest Health Problem, will be published by Oxford University Press and co-published by a scientific group, The International Association for the Study of Pain.

It’s a huge project and I’ve just started writing. I will talk about the enormity of the chronic pain problem in America㭂 million of us live in chronic pain,and a third are partially or totally disabled by it. Yet the federal government, that is, the National Institutes of Health, puts only about one percent of its budget into basic pain research, a scandal, in my view, given that pain is the main reason patients go to doctors! Yet doctors themselves know almost nothing about pain because they get only a few hours of training in pain over four years of medical school. (Even veterinary students get more.)

When it comes to drugs, we actually have two “competing” epidemics in this country, the epidemic of poorly treated pain, which stems in part from the fears of doctors, patients and regulators about using opioid drugs (narcotics)to treat pain, and the other epidemic— diversion of legitimate drugs and abusing them on the street. Nationally, we are totally schizophrenic about opioids—we fear them unnecessarily when we should be making them more available to patients in pain, and we allow them all too often to get into the hands of abusers.

There’ll be plenty of solid coping advice, but also some serious science (written in plain English) about how the nervous system turns short-term, acute pain into a self-revving system of chronic pain. I’ll talk about the genetics of pain—genes may explain as much as half of chronic pain. I’ll delve into the stunning gender issues of pain—why women get more pain yet are even less well treated for it than men. And, I’ll offer some solutions for fixing all this at the national level.

For a sampling of what’s to come, please listen to a September 28, 2010 WBUR interview I did on pain and gender.